Risks and complications of vaginal birth after cesarean

OBGYN Lauren Hyman, MD, explains the risks and complications for women associated with having a VBAC as opposed to having a second C-section
Vaginal Birth After Cesarean (VBAC) Risks & Concerns
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Risks and complications of vaginal birth after cesarean

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Why someone would would like to have a second cesarean section as suppose to trying to undergo a vaginal birth after cesarean section. Well about a 3rd of babies in the United States are delivered by cesarean section and all of these mothers, if they become pregnant again are going to have to make the decision of whether to undergo a trial of labor or simply to have a repeat cesarean section. And it’s a huge thing to consider. If you end up having a successful vaginal birth after cesarean section, the recovery time can be easier not having additional surgeries can be safer for the women. There are a lot of things to consider. That being said, when someone attempts to have a trial of labor and is unsuccessful, then there can be a lot more complications, and then if one had a cesarean section to begin with. There’s a higher risk of infection, recovery time can be longer, and the recovery process can be difficult. The other thing to consider is while it’s less than 1%, the big risk of having a trial of labor after the cesarean section is rupturing the uterus along the scar line in the uterus. If this happens the consequence are absolutely devastating and can be tragic for both the mother and the baby. There are certain situations that make rupturing the uterus slightly more likely being induced and having a scar in your uterus that goes up and down as opposed to a cross. If either of those situations is part of your history, you may consider wanting to just undergo repeat cesarean section to avoid the risk. Now coming back to whether or not you should try to have a vaginal birth after cesarean, knowing that if you succeed. But if you failed, the risk can be higher. I think we need to talk about, a little bit, why someone would be more likely to succeed with the vaginal birth and why one might be more likely to fail in having a vaginal birth after a cesarean section. We know that women that are shorter, have a higher body mass index, over 30 and have a bigger baby over 4000 grams are much less likely to have a successful vaginal birth after cesarean section, than women who do not have these factors. Also African American women and Latin women are less likely to be successful. We also know of the first cesarean section was done because of a failure to progress, or failure to be able to push the baby out. The chance that the next time around you will be able to have a successful vaginal birth is much less likely than if the cesarean section was done for instance for a breach presentation or for an emergency with the drop in the feel heart rate. So at the end of the day all women have to discuss the risk and the benefits of their particular situation with their doctor before deciding whether or not to have a V-back. If you find that you’re a risk of having a ruptured uterus, exceed what you are comfortable with or you know that your chance of been successful with a V-back maybe much lower than your okay with, you very well might decide that you want to get a good night sleep the night before, come in and have a repeat cesarean section that you know will likely be very safe for you and your new baby.

OBGYN Lauren Hyman, MD, explains the risks and complications for women associated with having a VBAC as opposed to having a second C-section

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Lauren D. Hyman, MD

Obstetrician Gynecologist

Dr. Lauren Hyman is a board-certified obstetrician gynecologist. After receiving her ScB from Brown University and her medical degree from Yale University, Dr. Hyman returned to Southern California where she has been in private practice in the West Hills area for fifteen years. She can be seen weekly on Hallmark Channelʼs Home and Family Pregnancy Series and is a contributing writer on mom.me. She lives with her husband and two children in Los Angeles.

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